Is 600CC - 650CC Too Big for Me and What Are the Risks?

Question

My surgery date us is on may 9. I am 5'6 145 pounds.I am 22 years old. I just had a baby on november 10,2010. No breast feeding. I was wondering if between 600cc and 650cc is too big for me.

	I tried on the 600cc and it was looking a little small. I am getting silicone gel high profile.I am going for an unatural look.

	My surgeon says I should have the Implant over the muscle. I am worried about bottoming out and sagging.I had my consultion a week ago and I have more quesions now then before

Steven S. Carp, MD · Answer

I would be very unusal for me to place a 600cc implant.  This is large.  The risks with large implants include.

	
		bottoming out
	
		thinning of the breast tissue and skin
	
		traction rippling
	
		unnatural looking breast


	The implant needs to match your body and breast dimensions, not just be big.

George Marosan, MD · Answer

The size of the implant is based on your chest wall and breast base measurement, taking into consideration the elasticity of the breast skin and sagging of the nipples. Your board certified plastic surgeon will make the size/volume recommendations for you. You said that you are going for the "unnatural look" , but worried about bottoming out and sagging. Well, you and your surgeon's choice of 600-650cc implants will guarantee you all that. I would consider a second opinion. It is easy to change your mind now and avoid several surgeries later. Good luck.

Mathew C. Mosher, MD · Answer

When considering any Cosmetic Plastic Surgery it is often all about reconciling what you want with what you can and should have. As other surgeons have commented, your chest and breast measurements are critical for planning and achieving optimal outcomes with breast augmentation surgery. An assessment of the quality of your tissue is also very important and can give the surgeon some ability to anticipate how your breast augmentation will look in the short term and estimate your risk for complications over the longer term. You have indicated that you " tried on the 600cc and it was looking a little small".   You are focusing on the short term outcome from your surgery and not placing appropriate emphasis on the risks associated with larger implants. This is always a concern for me. Even if you want a "fake" look you need to understand that your breasts will age and sag more quickly with larger implants and revisional surgeries will likely be more complicated and expensive than the original augmentation. Only your Plastic Surgeon can give you answers and perspective to these very important questions. Make sure you are making an informed decision.

	Dr. Mosher

	Plastic Surgeon

Paul Gill, MD · Answer

Larger implants increase the risk of complications such as implant malposition, which can be very difficult to correct longterm.  In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
	Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.

	The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
	I wish you a safe recovery and fantastic result.
	Dr. Gill

Tom J. Pousti, MD · Answer

It is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of &ldquo;goal&rdquo; pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as &ldquo;natural&rdquo; or &ldquo;C cup&rdquo; or "fake looking" means different things to different people and therefore prove unhelpful.
	Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
	I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
	I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
	By the way, the most common regret after this operation, is &ldquo;I wish I was bigger&rdquo;.
	I hope this helps.

Malik Kutty, MD · Answer

It sounds like the implants you're considering are pretty large for the frame size you described. Larger implants will definitely stretch the skin more and lead to sagging. While they may look the way you have in mind at first, they will not stay that way for long.

Peter E. Johnson, MD · Answer

The really full implant you are suggesting are not for everybody and you are right that the risks are higher. The risk is not bottoming out, or necessarily sagging, though the very large implants will thin the breast and can have a translucent quality as the light passes through. They also tend to round up and are rather obvious to even the casual observer. An experienced surgeon will also know that few can remain comfortable with such a full implant as they get older, and revision rates and breast lift rates are higher. Choose carefully. (Oh yes, over the muscle)

	Best of luck,

	peterejohnsonmd

Steven Wallach, MD · Answer

The implant syou chose seem pretty large, and usually the larger the implants the more likley problems can develop with the implants.

Kamran Khoobehi, MD · Answer

The size of the implant depends on the patient's breast base,chest width, and patient's expectations. 650 cc implant is too big and you will stretch you breast tissue and will need lift. Large implants have very high rate of complications including thinning of breast tissue, sagging ,bottoming out , rippling and unnatural look.

Jack Peterson, MD · Answer

The size of your implant depends on your chest wall measurements rather than your height and weight. In my practice I find the implant that matches your chest wall base width and then pick what implant projection will  match the number of cups larger you want to be. 

	This is a relatively large implant and you will need to trade off the unnatural look you want with the fact you will need to wear support because gravity will eventually take its toll.

Is 600CC - 650CC Too Big for Me and What Are the Risks?

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